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"Saat ini salah satu cara untuk mengetahui individu terkena penyakit kardiovaskular adalah dengan pemeriksaan kadar lemak dalam darah yaitu melalui laboratorium. Pemeriksaan secara laboratorium membutuhkan biaya yang relatif mahal dan memerlukan peralatan yang tidak sederhana. Berbagai penelitian telah membuktikan pengaruh pengukuran antropometri (indeks massa tubuh, lingkar perut dan lainnya) terhadap risiko penyakit kardiovaskular, namun sedikit penelitian yang menggunakan pengukuran tersebut sebagai alat skrining kadar lemak dalam darah. Salah satu pengukuran antropometri yang dianggap mudah dan sederhana adalah mengukur berat badan, tinggi badan dan lingkar perut. Metode penelitian cross sectional dengan menggunakan sampel orang dewasa sejumlah 20.782 jiwa. Hasil penelitian menunjukkan proporsi hiperLDL 16,07%, hipo HDL 18,83%, hiper trigliseridemia 4,23%,hiperkolesterolemia 8,37%, dislipidemia definisi pertama 14,42% dandislipidemia definisi kedua 33,88%. Hampir semua kelainan lemak darah,proporsi pada perempuan lebih banyak dibandingkan laki-laki kecuali hipo HDLlebih tinggi laki-laki dibandingkan perempuan. Rata- rata indeks massa tubuh danlingkar perut akan semakin meningkat terhadap kejadian kelainan lemak darahuntuk semua kondisi, baik laki-laki maupun perempuan. Jika dibandingkanberdasarkan jenis kelamin, rata-rata indeks massa tubuh dan lingkar perutperempuan lebih besar daripada laki-laki. Dengan menggunakan analisis ROCdidapatkan bahwa lingkar perut lebih baik dalam memprediksi dislipidemiadibandingkan dengan IMT dengan nilai AUC 59,56% pada laki-laki dan 60,93%pada perempuan.

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Until now one way to determine the potential of individuals exposed to

cardiovascular disease is to check the level of fat in the blood directly through the

laboratory. Laboratory examination requires a relatively expensive cost and

requires equipment that is not simple. Various studies have proven the effect of

anthropometric measurements (body mass index, abdominal and other

circumference) on the risk of cardiovascular disease, but few studies have used such

measurements as a screening tool for blood lipid levels. Anthropometric

measurements can be done in various ways, one of which is considered easy and

simple that is by measuring the weight, height and abdominal circumference.

Methods of cross sectional study using an adult sample of 20,782 inhabitants. The

results showed that the proportion of hyper LDL 16.07%, hypo HDL 18.83%, hyper

triglyceridemia 4.23%, hypercholesterolemia 8.37%, dyslipidemia first definition

14.42% and dyslipidemia second definition 33.88%. Almost all blood fat

abnormalities, the proportion in women more than men except HDV hypo is higher

for men than for women. The average body mass index and abdominal

circumference will increase in the incidence of blood lipid abnormalities for all

conditions, men or women. When compared by sex, the average body mass index

and abdominal circumference of women greater than men. ROC analysis showed

that abdominal circumference was better in predicting dyslipidemia compared with

BMI with AUC 59.56% in male and 60.93% in female."

"Latar belakang: Gagal jantung dekompensasi akut (GJDA) termasuk penyakit kardiovaskular dengan mortalitas serta tingkat readmisi yang tinggi. Resistensi insulin saat ini merupakan salah satu faktor yang dapat menjadi prediktor terhadap prognosis pasien GJDA. Indeks trigliserida glukosa (ITG) telah dilaporkan sebagai salah satu prediktor risiko kardiovaskular dan petanda resistensi insulin yang sederhana. Namun, hubungan ITG terhadap kejadian readmisi 30-hari dan kematian dalam 6 bulan pascarawat pasien GJDA masih belum diteliti.Tujuan: Mengetahui hubungan ITG dengan kejadian readmisi 30-hari dan kematian dalam 6 bulan pascarawat pasien GJDA yang dirawat pertama kali.Metode: Studi dilakukan dengan desain kohort retrospektif. Data subjek diambil dari rekam medis berdasarkan admisi pasien yang memenuhi kriteria inklusi dari Januari 2018 – November 2021. Luaran klinis yang dinilai adalah readmisi 30 hari dan kematian dalam 6 bulan pascarawat. Data tersebut diolah dengan analisis multivariat dan laju kesintasan pada subjek.Hasil: Total subjek dalam penelitian ini adalah 467 orang, dengan 158 subjek mengalami luaran klinis readmisi 30-hari dan kematian dalam 6 bulan pascarawat. Proporsi readmisi sebesar 29% (135 subjek) dan kematian dalam 6 bulan pascarawat sebesar 5% (23 subjek). Analisis multivariat menunjukkan bahwa faktor yang berhubungan dengan luaran klinis readmisi 30- hari adalah hipertensi (p 0.05, HR 1.493, 95% IK 1.019 – 2.187), usia (p 0.013, HR 0.98, 95% IK 0.964 – 0.996), fraksi ejeksi <50% (p 0.016, HR 1.888, 95% IK 1.124 – 3.172), tekanan darah sistolik saat admisi (p 0.012, HR 1.010, 95% IK 1.001–1.017), denyut nadi sebelum pulang (p 0.017, HR 0.989, 95% IK 0.979 – 0.998), gula darah puasa (p 0.017, OR 0.992, 95% IK 0.986 – 0.999), dan nilai ITG ( p <0.001, OR 28.9, 95% IK 10.112 – 83.068). Sedangkan faktor independen terhadap luaran kematian dalam 6 bulan pascarawat adalah tanpa penggunaan diuretik (p 0.02, HR 6.89, 95% IK 2.022 – 23) dan gula darah puasa (p 0.017, OR 0.992, 95% IK 0.986 – 0.999).Kesimpulan: Nilai ITG dapat menjadi prediktor readmisi 30-hari, namun tidak berhubungan dengan luaran kematian dalam 6 bulan pasarawat pada pasien GJDA

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Background: Acute decompensated heart failure (ADHF) is a cardiovascular disease with high mortality and readmission rates. Currently, insulin resistance has been reported to predict prognosis of ADHF patients. Triglyceride glucose index (TyG) has now been proposed as an independent predictor of cardiovascular risk and a simple marker of insulin resistance. However, the association between TyG and 30-days readmission and 6 months mortality after hospitalization remains unclear.

Objective: To investigate TyG as a predictor of 30-day readmission and 6 months mortality after hospitalization in ADHF patients.

Methods: The study was conducted in a retrospective cohort. Data were taken from medical records based on the admission of patients who met the inclusion criteria from January 2018 – November 2021. The clinical outcomes were 30-days readmission and 6 months mortality. The data were analyzed by multivariate analysis and the survival rate of the subjects.

Results: This study included 467 subjects, with 158 subjects have clinical outcomes. The readmission rate is 29% (135 subjects), and 6 month mortality after hospitalization is 5%. Multivariate analysis showed that the factors associated with 30-days readmission were hypertension (p 0.05, HR 1.493, CI 95% 1.019 – 2.187), age (p 0.013, HR 0.98, CI 95% 0.964 – 0.996), ejection fraction <50% (p 0.016, HR 1.888, CI 95% 1.124 – 3.172), systolic blood pressure on admission (p 0.012, HR 1.010, 95% CI 1.001 – 1.017), heart rate predischarge (p 0.017, HR 0.989, CI 95% 0.979 – 0.998), gfsting blood glucose (p 0.017, OR 0.992, CI 95% 0.986 – 0.999), dan TyG (p <0.001, OR 28.9, 95% IK 10.112 – 83.068). Independent factors for 6 months mortality were no diuretic medication (p 0.02, HR 6.89, 95% IK 2.022 – 23) and fasting blood glucose (p 0.017, OR 0.992, 95% IK 0.986 – 0.999).

Conclusion: Triglyceride glucose index can predict 30-days readmission, but does not associated with 6-months mortality in ADHF patients."

"schemic Heart Disease merupakan salah satu penyebab kematian paling umum di dunia dan frekuensinya terus meningkat setiap tahunnya. Hal ini menjadi tantangan yang besar bagi seorang Ners dalam pelayanan kesehatan di Indonesia. Praktik ilmu keperawatan yang berkualitas harus diimbangi dengan pembuktian secara Evidence Base Nursing (EBN) karena EBN bisa menjadi landasan dalam melaksanakan peran pemberi asuhan, pendidik, peneliti, dan innovator yang profesional. Praktik residensi telah memberikan pengalaman dan menambah pengetahuan residensi tentang keperawatan kardiovaskular. Penerapan teori Lydia Hall: Care, Core, dan Cure dilakukan oleh residensi pada 30 kasus resume dan satu kasus kelolaan yaitu pada pasien dengan STEMI. Peran peneliti telah dilakukan dengan menerapkan EBN tentang penerapan Slow Deep Breathing Relaxation Exercise (SDBRE) setelah chest tube removal pada pasien yang menjalani CABG di Ruang Intermediate Ward Bedah. Penerapan SDBRE didapatkan efektif dalam menurunkan nyeri setelah chest tube removal. Peran Inovasi dilakukan dengan menyusun protokol Munro Scale untuk mencegah kejadian Perioperative Related Pressure Injury pada pasien Bedah jantung. Munro Scale didapatkan mampu mendeteksi adanya resiko Pressure Injury, mudah dipahami oleh perawat, dan mudah dilaksanakan oleh perawat kamar bedah dalam perawatan. Namun sebaiknya follow up pengkajian Munro Scale dilakukan di ruangan ICU bedah, IW Bedah, dan Rawat Inap.

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Ischemic Heart Disease is one of the most common causes of death in the world and its frequency continues to increase every year. This is a big challenge for a nurse in health services in Indonesia. Quality nursing practice must be balanced with Evidence Based Nursing (EBN) evidence because EBN can be the basis for carrying out the role of professional caregivers, educators, researchers, and innovators. Residency practice has provided experience and increased residency knowledge about cardiovascular nursing. The application of Lydia Hall's theory: Care, Core, and Cure was carried out by residencies in 30 resume cases and one managed case, namely in patients with STEMI. The role of researchers has been carried out by applying EBN regarding the application of Slow Deep Breathing Relaxation Exercise (SDBRE) after chest tube removal in patients undergoing CABG in the Intermediate Ward of Surgery. The application of SDBRE was found to be effective in reducing pain after chest tube removal. The role of innovation is carried out by compiling the Munro Scale protocol to prevent Perioperative Related Pressure Injury in cardiac surgery patients. The Munro Scale was found to be able to detect the risk of Pressure Injury, easily understood by nurses, and easily implemented by operating room nurses in treatment. However, follow-up studies of the Munro Scale should be carried out in the surgical ICU, IW Surgery, and Inpatient rooms."

"Ners spesialis merupakan perawat lulusan program spesialis keperawatan yang mempunyai keahlian khusus dalam asuhan keperawatan. Perawat spesialis keperawatan medikal bedah peminatan kardiovaskular harus mempunyai kompetensi keperawatan inti dan keperawatan berbagai masalah kardiovaskular. Pendidikan residensi spesialis dilakukan selama 2 semester dengan tujuan utama melakukan asuhan keperawatan medikal bedah khususnya sistem kardiovaskular dengan menggunakan pendekatan teori kenservasi Levine. Asuhan keperawatan pada 1 kasus utama post operasi total koreksi TOF dan 30 kasus resume yang terdiri dari 6 kasus besar gangguan sistem kardovaskular meliputi kasus sindrom koroner akut, kelainan katup jantung, kelainan pembuluh darah, gagal jantung, kasus bedah (katup, CABG) dan disritmia. model konsep konservasi Levine dapat diterapkan pada pasien gangguan sistem kardiovaskular untuk mempertahankan wholeness dan adaptasi. Pemberian ice cube absorption dapat mengurangi sore throat pasca ekstubasi pasien bedah jantung. Proyek inovasi penerapan Awakening and Spontaneous Breathing Trial (SBT) Protocol pada pasien pasca bedah jantung yang terpasang ventilasi mekanik dan sedasi. Protokol mudah dipahami dan membantu perawat dalam proses weaning ventilasi mekanik.

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Nurse Specialist is an advanced practice nurse and have special skill in nursing care, graduate from the nursing specialist program. Nurse Specialist medical surgical nursing in cardiovascular specialization must have core nursing competencies and nursing of various cardiovascular problems. Specialist residency education is carried out two semesters with the aim of providing medical-surgical nursing care, especially the cardiovascular system, using Levine's conservation theory approach. Nursing care of one main case in after total correction TOF and thirty resume cases consisting of six major cases of cardiovascular system disorders: acute coronary syndrome, heart valve disorders, blood vessel disorders, heart failure, surgical cases (valve, CABG) and dysrhythmia. Levine's conservation concept model can be applied to patients with cardiovascular system disorders to maintain wholeness and adaptation. Ice cube absorption can reduce sore throat after extubation of cardiac surgery. An innovation project for the application of the Awakening and Spontaneous Breathing Trial (SBT) Protocol in post-cardiac surgery patients who are mechanically ventilated and sedated. The protocol is easy to understand and helps nurses in the process of weaning mechanical ventilation."

"Penyakit kardiovaskular merupakan sekumpulan penyakit yang mempengaruhi sistem peredaran darah termasuk jantung dan pembuluh darah, disebabkan oleh banyak faktor yang mencakup penyakit bawaan dan didapat. Penyakit kardiovaskular yang disebabkan oleh aterosklerosis meliputi penyakit arteri koroner, penyakit arteri serebral, dan penyakit arteri perifer dengan dua komplikasi utama infark miokard dan stroke iskemik. Perawat spesialis memiliki peran penting sebagai pemberi asuhan keperawatan langsung, peneliti, dan inovator. Peran sebagai pemberi asuhan keperawatan langsung dijalankan dengan mengelola satu kasus utama tentang asuhan keperawatan pada pasien pascaoperasi CABG dengan Low Ejection Fraction, PMI, dan topangan IABP serta 30 kasus resume keperawatan. Peran sebagai peneliti dijalankan melalui penerapan EBN tentang penggunaan gel ice pack untuk mengurangi nyeri pada pasien pascaoperasi jantung yang menjalani chest tube removal. Peran sebagai inovator dijalankan dalam penyusunan proyek inovasi tentang penerapan FICA Spiritual Assessment Tool untuk memenuhi kebutuhan spiritual pasien dengan gangguan sistem kardiovaskular. Hasil analisis praktik residensi menunjukkan bahwa pendekatan teori model konservasi Levine dapat diterapkan dalam pemberian asuhan keperawatan pada pasien dengan gangguan sistem kardiovaskular, pengaplikasian gel ice pack dapat mengurangi nyeri saat dilakukan chest tube removal pada pasien pascaoperasi jantung, dan instrumen FICA Spiritual Assessment Tool mudah untuk diterapkan sebagai upaya pemenuhan kebutuhan spiritual pasien dengan gangguan sistem kardiovaskular.

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Cardiovascular diseases are a group of diseases that affect the circulatory system, including the heart and blood vessels, caused by many factors that include congenital and acquired diseases. Cardiovascular diseases caused by atherosclerosis include coronary artery disease, cerebral artery disease, and peripheral artery disease, with two major complications: myocardial infarction and ischemic stroke. Specialist nurses play an important role as direct nursing care providers, researchers, and innovators. The role of direct nursing care providers is carried out by managing a major case of nursing care for post-CABG patients with Low Ejection Fraction, PMI, and IABP support, as well as 30 nursing resume cases. The role of researchers is carried out through the application of EBN on the use of ice pack gel to reduce pain in post-cardiac surgery patients undergoing chest tube removal. The role of innovators is carried out in the preparation of innovation projects on the application of the FICA Spiritual Assessment Tool to meet the spiritual needs of patients with cardiovascular disorders. The results of the residency practice analysis show that Levine's conservation model theory approach can be applied in providing nursing care to patients with cardiovascular disorders, the application of ice pack gel can reduce pain during chest tube removal in post-cardiac surgery patients, and the FICA Spiritual Assessment Tool is easy to apply as an effort to meet the spiritual needs of patients with cardiovascular disorders."

"[ABSTRAK Penyakit kardiovaskular seperti gagal jantung kongestif memiliki prevalensi yang tinggi yang dapat disebabkan oleh perubahan pola hidup pada masyarakat urban. Kenaikan prevalensi penyakit kardiovaskular berhubungan dengan proses urbanisasi yang progresif dan globalisasi dari pola hidup tidak sehat yang ada pada masyarakat urban atau perkotaan. Tanda klinis yang muncul serta proses hospitalisasi dapat menjadi salah satu faktor munculnya masalah psikososial pada pasien gagal jantung kongestif. Masalah psikososial yang sering ditemukan adalah ansietas. Penulisan karya ilmiah ini bertujuan memberikan analisis mengenai asuhan keperawatan ansietas pada pasien gagal jantung kongestif. Intervensi yang dianalisis meliputi relaksasi napas dalam, hipnosis lima jari, distraksi sosialisasi dan pemberian informasi. Evaluasi tindakan menunjukan bahwa lebih banyak tanda gejala yang menghilang saat memberikan kombinasi tarik napas dalam dan hipnosis lima jari selama lima hari perawatan. ABSTRACT Cardiovascular disease such as congestive heart failure have high prevalence due to the transition of lifestyle in urban society. The increase of prevalence relates to the progressive and global urbanization which has unhealthy sedentary lifestyle in urban society. The presence of sign and symptom or hospitalization may cause the psychosocial problem in patient with CHF such as anxiety. The objective was to analyze the psychosocial nursing care plan specifically anxiety in CHF patient. Nursing intervention which has given are deep breathing relaxation, five finger hypnosis, distraction and health education. It shows that sign and symptom of anxiety decreased significantly when deep breathing and hypnosis is combined.;Cardiovascular disease such as congestive heart failure have high prevalence due to the transition of lifestyle in urban society. The increase of prevalence relates to the progressive and global urbanization which has unhealthy sedentary lifestyle in urban society. The presence of sign and symptom or hospitalization may cause the psychosocial problem in patient with CHF such as anxiety. The objective was to analyze the psychosocial nursing care plan specifically anxiety in CHF patient. Nursing intervention which has given are deep breathing relaxation, five finger hypnosis, distraction and health education. It shows that sign and symptom of anxiety decreased significantly when deep breathing and hypnosis is combined.;Cardiovascular disease such as congestive heart failure have high prevalence due to the transition of lifestyle in urban society. The increase of prevalence relates to the progressive and global urbanization which has unhealthy sedentary lifestyle in urban society. The presence of sign and symptom or hospitalization may cause the psychosocial problem in patient with CHF such as anxiety. The objective was to analyze the psychosocial nursing care plan specifically anxiety in CHF patient. Nursing intervention which has given are deep breathing relaxation, five finger hypnosis, distraction and health education. It shows that sign and symptom of anxiety decreased significantly when deep breathing and hypnosis is combined.;Cardiovascular disease such as congestive heart failure have high prevalence due to the transition of lifestyle in urban society. The increase of prevalence relates to the progressive and global urbanization which has unhealthy sedentary lifestyle in urban society. The presence of sign and symptom or hospitalization may cause the psychosocial problem in patient with CHF such as anxiety. The objective was to analyze the psychosocial nursing care plan specifically anxiety in CHF patient. Nursing intervention which has given are deep breathing relaxation, five finger hypnosis, distraction and health education. It shows that sign and symptom of anxiety decreased significantly when deep breathing and hypnosis is combined.;Cardiovascular disease such as congestive heart failure have high prevalence due to the transition of lifestyle in urban society. The increase of prevalence relates to the progressive and global urbanization which has unhealthy sedentary lifestyle in urban society. The presence of sign and symptom or hospitalization may cause the psychosocial problem in patient with CHF such as anxiety. The objective was to analyze the psychosocial nursing care plan specifically anxiety in CHF patient. Nursing intervention which has given are deep breathing relaxation, five finger hypnosis, distraction and health education. It shows that sign and symptom of anxiety decreased significantly when deep breathing and hypnosis is combined., Cardiovascular disease such as congestive heart failure have high prevalence due to the transition of lifestyle in urban society. The increase of prevalence relates to the progressive and global urbanization which has unhealthy sedentary lifestyle in urban society. The presence of sign and symptom or hospitalization may cause the psychosocial problem in patient with CHF such as anxiety. The objective was to analyze the psychosocial nursing care plan specifically anxiety in CHF patient. Nursing intervention which has given are deep breathing relaxation, five finger hypnosis, distraction and health education. It shows that sign and symptom of anxiety decreased significantly when deep breathing and hypnosis is combined.]"